Get back to your fit shape with post-natal surgery

Aesthetic, Plastic and Reconstructive Surgery Specialist Op. Dr. Hakan Gündoğan, gave information relating with the correction of deformities around various parts of the body.

With its popular name in USA “Mommy Makeover” or “Post-natal aesthetic surgery” concept generally includes various surgical methods applied on abdomen and breasts, parts that are affected by the pregnancy and birth giving procedure, in order to bring the irreversible effects pregnancy created on the female body back to normal or even better condition. Starting with the moment of pregnancy, a woman’s body gave all its priorities to the baby that is developing inside. Hormonal and mechanical changes, though effective in almost every part of the body, show their most apparent effects on abdominal region and breasts. Normally at the size of an orange, uterus starts pushing the abdominal wall forward with the growth of the baby and maybe shows its most irreversible effects on the abdominal muscles and ligaments that attach them to each other, and cause them to stretch irreversibly. The real reason for the abdominal bulge seen especially in slim women and looks camber or even as if in the beginning of pregnancy though extra skin is minimal, is that abdominal muscles that lost this elasticity cannot support the intra-abdominal organs sufficiently and almost outward herniation of these organs. As the pregnancy progresses and the baby grows, not only the abdominal muscles and ligaments but at the same time sub-dermal fatty tissue and skin itself undergo changes. Sub-dermal fatty tissue gets thicker in order to create sufficient coverage and protection, while the skin stretches thanks to the elastic fibers within in order to adjust to the expanding abdomen volume. If this tension is too high to cause separation of the skin and elastic fibers or is genetically too weak, “stretch marks” can be seen especially below the belly. All these changes on skin and sub-dermal level occur also on the breasts. At the same time, the belly button will change its form due to the tension and become more bulged and bigger. Naturally all of these changes become much more apparent especially in twin pregnancies and extreme weight gaining during pregnancy (especially more than 15-20 kg).


During pregnancy, fat accumulations can occur as one of the protective mechanisms of the body. Fat accumulation, though the reason cannot be exactly known, can be seen especially on waist, hip and buttocks along with the other regions of the body. The main reason for the patients’ complaints generally after giving birth about the waist thickening is this fat accumulation. When there is an adiposity complaint in back, waist, hip, inner knee and neck regions, Liposuction is a very appropriate choice and there is a high chance of getting positive results. The fat intensity of these regions is richer than collagen, and the skin above them is more tight and suitable for stretching. On the other hand, before applying Liposuction on especially post-natal abdominal region, the patients must be very carefully studied.


A small bulge right under the belly button is a natural anatomic characteristic even for the athletic women. When the increase of this bulge in women that especially came back to her ideal weight after birth is mistakenly considered as a fat accumulation and when tried to be corrected with Liposuction, failure is a guarantee. The reason for this situation is the abdominal muscles that loosened during pregnancy, and in situations where they cannot be tightened with sport the procedure to be followed is not Liposuction, but the tightening of these muscles surgically whether along with a mini abdominal wall tightening surgery (by using cesarean marks if the birth was given through cesarean). Again, Liposuction procedure to be conducted for loose skin in addition to the remaining extra fat in the abdominal region after birth will cause more sagging of the abdomen! Because the only skin that can be tightened in situations where there is minimal loose skin on abdomen after pregnancy is below the belly, the method called as “mini abdominoplasty” or “mini abdominal wall tightening” will be sufficient. The procedure is to tighten the lower belly region by taking out extra skin with the help of a cut that is done via stretching the cesarean mark maybe a little more. The repair of the stretch of the abdominal muscles is possible meanwhile. The best results for patients that have extreme adiposity in the abdominal region and sever skin sagging can be achieved with “full abdominoplasty or full abdominal wall tightening” operation. Though this operation requires a bigger surgical process, it is one of the most positive-resulting procedures of plastic surgery, as long as the health of the patient is not put at risk (whether the patient gave birth or not).


One of the regions that is affected severely by the pregnancy process is the breasts. With the effect of the hormones during pregnancy, the breasts almost always grow bigger due to the increase of mammary glands and the encircling fatty tissues. At the same time, fibers that hold the breast tissue stretch and the skin above it responds to this stretching. These changes go on not only during pregnancy but all through the breastfeeding period. Especially depending on the size of the breasts before pregnancy, these changes differ in every woman. The generally encountered situation is the breasts’ loss of old volumes and their sagging. Typically patients complain about the condition of “emptied breasts”. If breasts are big enough prior to pregnancy, the result is that they still sag though they have the sufficient volume. The generally accepted view today is that the deformities seen on the breasts after birth is not as a result of breastfeeding but because of the changes the body shows during the pregnancy process. Aesthetic attempts towards breasts after pregnancy are totally planned in accordance with the changes and patient’s request. Some patients always complained about having big breasts, and though they wanted a “breast reduction surgery”, they postponed this request after birth and breastfeeding. For patients that consider another baby, it is required to use techniques that protect the nipple and sufficient breast tissue when reducing their breast so as not to create breastfeeding problems in the future. Similarly, some patients that always complained about having small breasts will have the chance to have the breasts they desired with “breast augmentation” operation following the end of breastfeeding. When there is sagging of the breasts in question, “breast lifting” operation is recommended to patients. When there is serious volume loss in breasts in addition to sagging, a breast implant is needed to be placed during breast lifting operation in order to create fullness.


The least mentioned plastic surgery applications in a post-natal period are the operations that include external genital organs. When normal delivery and sometimes episiotomy (opening a cut in the vaginal wall in order to widen the area for baby to exit) are added to the changes that take place in these organs especially during pregnancy, there can be problems that bother women both aesthetically and functionally. Especially the sagginess and extreme size of the labia minora can disturb women but this can be solved with a very simple operation.


At least 6 months must pass in order to start any surgical attempt in a female body after birth. Any attempt on the breasts must be a minimum of 3 months later from the breastfeeding, and the ideal is 6 months later. During this period of time, the body will try to minimize all the changes brought by the pregnancy. At the same time the weight managements of the patients must be dealt with professionally and they should lose weight in a healthy way with the help of appropriate diet and sport. The most suitable candidates for the post-natal aesthetic attempts are mothers, who had sufficient time period after birth giving, stopped breastfeeding, reached her ideal weight, without any help problems and has reasonable expectations. As a result it is possible to reverse most of the deformities occurring on the body after pregnancy, or acquire body contours better than before pregnancy. However it should be noted that not everyone is suitable for aesthetic surgery. When you feel physically and spiritually ready, and believe that the result you will get after operation will make you feel better and more self-confident, it is beneficial to knock on the door of your plastic surgeon.